Jolley, Timothy B
Jolley, Timothy B is an individual health care provider with primary practice located at 1322 3Rd St Se Ste 240 , Puyallup WA 98372-3771. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Jolley, Timothy B can be contacted via phone (253) 848-1572.Contact Information
Primary practice address
1322 3Rd St Se Ste 240
Puyallup WA 98372-3771
Phone: (253) 848-1572
Fax: (253) 841-3719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00015352 | Washington |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00015352 | Washington |
Profile Details
| NPI number | 1407907504 |
|---|---|
| LBN Legal business name | Jolley, Timothy B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Feb 16th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407907504 | NPPES |
| Washington | MEDICAID | 1001502 |
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